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BLUE BADGE APPLICATION GUIDANCETelephone enquiries: 0300 500 80 80

Monday to Friday: 8am-6pm

This document applies to all applications including re-applications for previous badge holders. You will be assessed on the information you supply on this application form only and not on information previously supplied. We do not hold historical application data for review and therefore it is the applicant’s responsibility to provide as much detail and evidence as possible now. Your application is likely to be unsuccessful if you do not provide enough detail, as well as adequate evidence, to meet the current eligibility criteria.

We will aim to process all applications as quickly as possible, but please allow up to twelve weeks for processing of all applications. This includes if you have held a badge previously.

The aim of the scheme is to help disabled people with severe physical and non-physical problems to access goods and services, by allowing them to park close to their destination. The scheme is open to eligible disabled people irrespective of whether they are travelling as a driver or as a passenger. The scheme provides a national range of on-street parking concessions for Blue Badge holders who are traveling either as a driver or passenger.

It is the responsibility of each local authority to ensure that badges are only issued to residents who satisfy one or more of the eligibility criteria set out in the legislation that governs the scheme. Under no circumstances should anyone who does not satisfy at least one of the criteria receive a badge. Badges should never be issued to people solely on the basis of their age and/or medical condition and should not be issued for any purpose other than to assist the recipient when undertaking journeys.

NCC have put in place administration and assessment practices that are: fair and consistent in their treatment of Blue Badge applicants customer-friendly and clear timely and cost efficient resistant to abuse

You can access further information regarding eligibility criteria here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/809057/blue-badge-scheme-local-authority-guidance.pdf

The Blue Badge application form is divided into different sections. The following guidance will support you in making your application.

Section 1 – Information about you

Payment – A Blue Badge costs £10. This is the only payment you make as part of the application process. If your application is successful you will be contacted to make this payment prior to a badge being issued. If you provide an email address for contact, we will be able to send you a link to make the payment online.

Your information - If you are completing the form on behalf of an applicant who is under 16 or who is unable to complete the form themselves, please provide their details in all appropriate sections and sign the form on their behalf.

Previous address – it is important to add your previous address if you have moved in the last 3 years, as this helps us to locate your previous badge issue record.

Preferred method of contact – unless stated otherwise, where an email address has been provided, NCC will use email as the preferred method of contact.

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BB/Form/1aHSection 2 – People who automatically qualify for a badge:

If you are in receipt of one of the qualifying benefits stated in Section 2, please complete the box that is applicable to you and return the application for processing with your supporting documents as required. A person is automatically eligible for a badge if they are over two years old and meet at least one of the following criteria:

receives the Higher Rate Mobility Component of the Disability Living Allowance; please attach a copy of the letter from DWP confirming your entitlement to the Higher Rate Mobility Component of Disability Living Allowance, dated within the last 12 months. If you need an up-to-date letter, you will need to contact the Department for Work and Pensions on 0800 121 4600 or email: DCPU.Customer-Services@dwp.gsi.gov.uk (If your date of birth is on or before April 8th 1948, you will need to contact 0800 731 0122). Open Mon-Fri 7.30am-6.30pm

receives Personal Independence Payment for being unable to walk further than 50 metres (a score of 8 points or more under the ‘Moving around’ activity of the Mobility component); or

score 10 points under Activity 11, descriptor E in the “Planning and following a journey” activity of the Mobility component, which states – You cannot undertake any journeys because it would cause overwhelming psychological distress

Please attach a photocopy of the full letter from DWP, confirming your entitlement to the relevant points descriptors above, dated within the last 12 months. The letter should show your entitlement to PIP and your assessment scores. We will accept your most recent decision letter showing your assessment scores provided it is supported by your yearly update letter (dated within the last 12 months). If you need an up-to-date letter you will need to contact the Department for Work and Pensions on 0800 121 4433. Open Mon-Fri 8.00am-6.00pm.

If you are applying for a badge under any of these criteria you will automatically qualify, provided you have the right documentation to support your application and can provide proof of your identity and proof that you are a resident in the local authority in which you are applying.

If you do not provide us with the proof of your entitlement to the relevant automatic criteria listed above, we will not be able to continue with your application under the automatic criteria.

People who may also qualify for a badge

Some people may also be eligible for a badge if they are more than two years old, have an enduring and substantial disability which may be described as the following:

- Be unable to walk or have very considerable difficulty in walking.- Experience very considerable difficulty whilst walking, which may include very considerable

psychological distress; or- Be at risk of serious harm when walking; or pose, when walking, a risk of serious harm to any other

person

Section 3 – ‘Hidden’ or ‘Non-physical disabilities’

Section 3, 4 & 5 should be completed if you experience any ‘non-physical’ disabilities (such as very considerable psychological distress) which cause you very considerable difficulty whilst walking as part of a journey. You should also complete this section if, when walking as part of a journey, you pose a risk of serious harm to yourself or others. Please provide as much detail as possible to support your application.

The applicant will need to show that as a result of their enduring and substantial disability, they are unable to walk; Experience very considerable difficulty whilst walking, which may include very considerable psychological distress; or Be at risk of serious harm when walking, to the extent that they would be unable to access goods and services unless allowed to park close to shops, public buildings and other facilities.

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BB/Form/1aHSection 3 - Make sure you provide ALL conditions that affect your walking at the time of application. Give as much detail as possible in your descriptions of how your walking is affected.

Section 4 – please provide as much information as possible about your treatment and medications. If you take many medications, you can choose to enclose a copy of your prescription rather than write them all down.

In order for your application to be processed, you will also need to include supporting evidence, such as those listed on page 16 of the application (such as consultant/diagnosis letters, care plans, EHCP, physiotherapy). If you do not supply this evidence, we will be unable to process the application. Please only attach copies of documents as we cannot return original documents.

Please be aware that evidence from GPs in support of applications, will only be considered provided this is not the only source of evidence that is used to determine the eligibility of a Blue Badge application. This is because a General Practitioner cannot fulfil the role of ‘eligibility assessor’.

Section 5 - You may be asked to have an eligibility assessment with one of our assessors. If you are asked to have an eligibility assessment and you either do not agree, or do not attend, we will not be able to continue with your application.

We will write to you with the relevant details should you be required to attend an eligibility assessment.

Please note, any questions left incomplete or unanswered will not be taken into consideration. Ensure you answer all relevant questions in full.

Unsuccessful applications

Your local authority will decide if you are eligible for a Blue Badge. Eligibility will be determined on the information you have supplied in your application along with any supporting documents provided. If they decide that you are not eligible, and you think that they did not take all the facts into account, you can ask them to consider your application again. You can write to Nottinghamshire County Council, within 60 days of the unsuccessful application, asking for a review of your application stating what information you feel was not considered and providing any new information that was not in the original application.

However, unless the applicant can provide further evidence in support of their application (information not previously provided), or their condition has significantly deteriorated since they applied for the Blue Badge, then the decision is unlikely to be changed. As part of this review you may be asked to have a face-to-face assessment with an eligibility assessor.

A local authority may also refuse to issue a badge if they have reason to believe that the person applying for it is not who they claim to be or that the badge would be used by someone else. They can also refuse to issue a badge if you do not supply sufficient evidence that you are eligible.

The primary aim of the Blue Badge scheme is to give support to disabled people who rely on car travel but face particular challenges in getting from the car to their destination, and therefore need the ability to park close by. The awarding of a badge should directly benefit the individual. To ensure the sustainability of the scheme, badges should not be awarded in situations where the carer is effectively the beneficiary.

Supporting documents (Identification) – We need to verify your identity and address in order to process your application. We can automatically do this via ‘TransUnion’ using your name, address and date of birth (if over the age of 18). If you choose this option, you will not be required to post/email in proof of address or identity.

Information regarding ‘TransUnion’ can be found on the below websites: https://www.transunion.co.uk/products-and-services/fraud-and-id/callvalidate orNottinghamshire County Council Privacy statement or http://www.nottinghamshire.gov.uk/globalcontent/privacy

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BB/Form/1aHIf you choose to send in documents, please only attach photocopies as we cannot return original documents. All documents are destroyed through confidential waste once an application has been processed.

Proof of Address – copies of

Current Council Tax bill bearing my name and address, dated within the last 12 months Valid driving licence

Benefit letter from the DWP dated within the last 12 months

Pension letter from the Pension Service dated within the last 12 months

If under 16, a confirmation letter from the school the child attends

Housing benefit (or other benefit) letter dated within the last 12 months

Award letter from the Service Personnel and Veterans agency dated within the last 12 months

A confirmation letter from Social Services or other Local Authority service confirming the customer is

resident at that address.

Proof of identity – copies of

Passport

Valid driving licence

Birth/Adoption Certificate

Marriage/Divorce Certificate

NCC Bus Pass

Certificate of British Nationality

HMS Forces Card

Identity Card for foreign nationals

Power of Attorney We can only send a badge to the permanent residence address for the applicant. If the Blue Badge is required to be sent elsewhere, we will only be able to do this if a copy of power of attorney is supplied with the application.

Photo Guidance

One recent passport sized photo clearly showing their full face so that they can be easily identified. (Please print the name and post code of the applicant on the back of the photo.

The photograph must be a close-up, digital photograph of the head and shoulders of the badge holder, the of the same standard as those used for passports and must have been taken in the last month. It must be of the applicant’s full face and no-one else should be in it. The photograph will be placed on the back of the badge and will not be visible when the badge is being displayed in the vehicle. Photographs that do not meet the correct standard will be returned.

If you already hold a blue badge and the photo on your current badge is a true likeness of you, we can use this for a maximum of 3 badge issues.

The photograph is a key feature in reducing abuse of the scheme and enabling effective enforcement.

We will aim to process all applications as quickly as possible, but please allow up to twelve weeks for processing of all applications. This includes if you have held a badge previously.

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If you have returned your application form and documents, we kindly ask that you do not call to check on progress before 12 weeks have passed due to the volume of applications that we receive. We will contact you if we require any further information.

Return your completed form to: The Blue Badge TeamNottinghamshire County CouncilCustomer Service CentrePO Box 9320NottinghamshireNG15 5BL

Tel: 0300 500 80 80

Email: bluebadge@nottscc.gov.uk

Please ensure that the correct postage fee has been paid as we cannot guarantee delivery for underpaid mail. Large letters may cost over £2.50 for 1st class. Please refer to Royal Mail or your local post office for further guidance.

Alternatively, you can take your completed application form to one of our customer service points who will send the application for you.

You can find the location of these at https://www.nottinghamshire.gov.uk/contact-and-complaints/contact-us/visit-us or by calling the Customer Service Centre on 0300 500 80 80.

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BB/Form/1aHBLUE BADGE APPLICATION

Telephone enquiries: 0300 500 80 80 Monday to Friday: 8am-6pm

Please complete all relevant sections of the application form and supply the appropriate documents to confirm your address, identity and evidence of eligibility. The local authority may refuse to issue a badge if you do not provide adequate evidence that you meet the eligibility criteria.

Payment – A Blue Badge costs £10. This is the only payment you make as part of the application process. If your application is successful you will be contacted to make this payment prior to a badge being issued. If you provide an email address for contact, we will be able to send you a link to make the payment online. You will also need to provide a recent passport size photograph.

We will aim to process all applications as quickly as possible, but please allow up to twelve weeks for processing all applications. This includes if you have held a badge previously.

Please ensure that the correct postage fee has been paid as we cannot guarantee delivery for underpaid mail.

Section 1 – Information about youIf you are completing the form on behalf of an applicant who is under 16 or who is unable to complete the form themselves, please provide their details in appropriate sections and sign the form on their behalf.

Title: Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Other ☐

Forename:

Surname: Surname at Birth:

Gender: Man or Boy ☐ Woman or Girl ☐ Identify in a different way ☐ ______________________

Date of Birth: Place of Birth:

National Insurance No.

NHS No. (10 digits)

Address: (this is where the badge will be posted to)

Previous Address: (if you have moved in last 3 years)

Home No. Mobile No.Email address:What is your preferred method of contact for correspondence?(Unless otherwise stated NCC will use email as a preferred method of contact)☐Email ☐Post

If you currently hold a badge, please answer the following:

Which Local Authority issued the badge?Badge serial number (1st six digits)Expiry date of current badge

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Application for: ☐New Badge ☐ Reapplication for existing badge Expiry date: ………/..……/..……

BB/Form/1aHDeclaration

By submitting this application, you agree that: you have read and understand the rules for using a Blue Badge the details provided are complete and accurate you won't hold more than one Blue Badge at any time you will tell Nottinghamshire County Council about any changes that may affect your eligibility

You also agree that Nottinghamshire County Council may: contact you if there are any issues with this application or to prevent badge misuse if required, arrange a phone-based or in-person assessment for you check your eligibility with the information they hold and have access to suggest other benefits or services that you may be eligible for

By signing below, you confirm your agreement to all of the above declarations

Your Signature………………………………………….. Date of Application……………………………

If you are signing on behalf of someone else, please give your name and your relationship to the applicant:

Name……………………………………………………... Relationship……………………………………

Supporting documents (Identification) – We need to verify your identity and address in order to process your application. We can automatically do this via ‘TransUnion’ using your name, address and date of birth (if over the age of 18). If you choose this option you will not be required to post/email in proof of address or identity, providing the check is successful.

Information regarding ‘TransUnion’ can be found on the below websites: https://www.transunion.co.uk/products-and-services/fraud-and-id/callvalidate orNottinghamshire County Council Privacy statement

I give permission for you to verify my identity and address with TransUnion or I confirm the applicant has given their permission and I have signed on their behalf.

Alternatively, please see list of required documents in the guidance supplied, should you wish to send photocopies

Photo

You’ll need a photo to be printed on the back of the Blue Badge. The requirements are similar to a passport photo. You may attach your photo in the space below:

Make sure it:

Has a plain, light, background Includes face and shoulders Shows the face clearly Is a true likeness

Vehicle Registration

Do you drive yourself, or do you normally travel in a specific motor vehicle?

☐ Yes – Enter the vehicle registration number/s here: _____________ _____________ ___________

☐ No – if there is no main vehicle you travel in, please select this option

The following application is divided into different sections.

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If you already hold a blue badge and the photo on your current badge is still a true likeness of you, we can use this for a maximum of 3 badge issues.

If we do not receive a photo with your application, we will assume confirmation of true likeness and your consent to re-use this photo.

BB/Form/1aHIf you are in receipt of one of the qualifying benefits stated in Section 2, please complete the box that is applicable to you and return the application for processing with your supporting documents as required.

If you answer no to all of section 2, you are required to complete a further assessment under sections 3, 4 and 5. This is where you will be asked to detail your medical conditions and how they affect you. Please provide as much detail as possible to support your application.

Disability Living Allowance (Higher Rate Mobility)

A) Do you receive Disability Living Allowance at the Higher Rate for the Mobility component?

Yes No

Have you been awarded this (please tick which applies)?

Indefinitely With and end date – please state: DD MM YYYY

Please attach a copy of the letter from DWP, confirming your entitlement to the Higher Rate Mobility Component of Disability Living Allowance, dated within the last 12 months. If you need an up-to-date letter you will need to contact the Department for Work and Pensions on 0800 121 4600 or email: DCPU.Customer-Services@dwp.gsi.gov.uk (If your date of birth is on or before April 8th 1948, you will need to contact 0800 731 0122). Open Mon-Fri 7.30am-6.30pmIf you are in receipt of the Higher Rate Mobility Component of Disability Living Allowance and do not provide us with the information requested, we will not be able to continue with your application.

Personal Independence Payment (Mobility component)

B) Did you score 10 points in Activity 11 descriptor E in the “Planning and following a journey” part of the Mobility component which states:

10 Points – You cannot undertake any journeys because it would cause overwhelming psychological distress. Yes No

Have you been awarded this (please tick which applies)?

Ongoing With an end date – please state: DD MM YYYY

C) Do you score 8 points or more in the ‘Moving around’ descriptor for the Mobility component?

Yes – how many points were scored? ______ No

Have you been awarded this (please tick which applies)?

Ongoing With an end date – please state: DD MM YYYY

Please attach a photocopy of the full letter from DWP, confirming your entitlement to the relevant points descriptors above, dated within the last 12 months. The letter should show your entitlement to PIP and your assessment scores. We will accept your most recent decision letter showing your assessment scores provided it is supported by your yearly update letter (dated within the last 12 months). If you need an up-to-date letter you will need to contact the Department for Work and Pensions on 0800 121 4433. Open Mon-Fri 8.00am-6.00pm. If you do not provide us with the information requested, we will not be able to continue with your application.

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Section 2 – Please tick the section that applies to the applicant

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1. Please name any health conditions or disabilities that cause you to struggle with your journeys – (try to use the correct medical terms if you know them and be as descriptive as possible)

2. What affects you taking a journey between a vehicle and your destination? – please tick all that apply

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2a. ☐ I am a risk to myself or others near vehicles, in traffic or car parks

When are you a risk to yourself or others? – please circle the relevant answer☐ Almost never☐ Sometimes☐ Almost every journey ☐ Every journey

Section 3 - ‘Hidden’ or ‘Non-physical’ disabilities

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2a. ☐ I am a risk to myself or others near vehicles, in traffic or car parks

When are you a risk to yourself or others? – please circle the relevant answer☐ Almost never☐ Sometimes☐ Almost every journey ☐ Every journey

2b. ☐ I struggle to plan or follow a journey

What journeys does this apply to?

☐ Unfamiliar journeys☐ Every journey

2c. ☐ I find it difficult or impossible to control my actions and lack awareness of the impact they could have on others

How often does this happen?

☐ Almost never☐ Sometimes☐ Almost every journey ☐ Every journey

Please describe the kinds of incidents that have happened on journeys

2d. ☐ I regularly have intense responses to overwhelming situations causing temporary loss of behavioural control

How often does this happen?

☐ Almost never☐ Sometimes☐ Almost every journey ☐ Every journey

Please give examples of the situations that cause temporary loss of control

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2e. ☐ I can become extremely anxious or fearful of public/open spaces

When do you become extremely anxious/fearful?

☐ Almost never☐ Sometimes☐ Almost every journey ☐ Every journey

Please describe the levels of anxiety

2f. ☐ Something else

Describe what affects you taking a journey between a vehicle and your destination?

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3. How would a Blue Badge improve taking a journey between a vehicle and your destination? (please describe your needs in detail).

4(a). What steps are currently taken to try to improve journeys for you between a vehicle and your destination?

List the measures taken to try to improve journeys

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(b). How effective are they?

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BB/Form/1aH5 Do

your health conditions affect your walking all the time?

☐Yes ☐No

6 (a). Do you take pain relief medication?

☐Yes – please answer below☐No

6 (b). Describe the pain you experience when walking (please tick all that apply)

☐ When I take my pain relief medication I am able to cope with the pain ☐ Even after taking pain relief medication I have to stop and take regular breaks☐ Even after taking pain relief medication the pain makes me physically sick☐ Even after taking pain relief medication I am frequently in so much pain that walking for more than 2 minutes is unbearable☐ Other – please describe the pain:

7. Do you have help to get around? - please tick all that apply

☐ 1 Walking stick☐ 1 Elbow crutch ☐ Walking Frame☐ Wheelchair☐ Other – please state below

Please describe when you use the aids you have selected above

8.How long can you walk for using a mobility aid without stopping? – If you listed an aid, then your

answer should be when using that aid.

Stopping could be to take a rest or to catch your breath – please only tick one box

☐ I can’t walk at all☐ Less than a minute☐ Between 1 and 5 minutes☐ Between 5 and 10 minutes

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☐ 2 Walking sticks☐ 2 Elbow crutches ☐ Rollator☐ Support of a person/s

BB/Form/1aH☐ More than 10 minutes

If you cannot walk, go to section 5

9. Describe somewhere you can walk from and to using a mobility aid – please be specific and use place names, house numbers, landmarks. For example, “from my home at 24 to Tesco on Main Road”

10. How long does this journey take you? – for example, 8 minutes (If you are using a walking aid your answer should be whilst using that aid)

Treatments

11. Has your condition required any treatments? – This could have been in the last 10 years, ongoing or any treatment you have booked in the next 3 years. List any surgeries, treatments or clinics that are to do with your condition.

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Section 4 – Treatments, medication, associated professionals and documents.documents.

BB/Form/1aH☐ Yes – Add the treatment details below☐ No – go to Medication

Date of treatment Describe the treatment

Medications

12. Do you take any medication for your condition? – Any medication or pain relief you currently take for your condition.

☐ Yes – add the medication details below☐ No – go to associated professionals

You may enclose a copy of your prescriptions if you wish.

Name of medication or pain relief

Is this pain relief?

Yes or No

Prescribed Yes or No

Dosage – how much do you

take each time

Frequency – how often do you take this

13. Associated or healthcare professionals

Do you currently see any professionals for your condition? – Or if you have seen any in the last 3 years.

☐ Yes – Add their details below☐ No – go to Supporting documents

Professional Name and role

Where do they work Email address if known Contact Number if known

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You may be asked to have an eligibility assessment with one of our assessors. Please tick the following statement to say that you agree to this. If you are asked to have an eligibility assessment and you either do not agree, or do not attend, we will not be able to continue with your application

☐ I understand that I may be required to undertake an eligibility assessment with a healthcare professional that is independent of my existing care and treatment, in order to determine my eligibility for a Blue Badge.

☐ Please tick this box if you get, or have had, social care support from the Council, for example, aids and adaptations to your house. If you get social care support from the Council, we will check our social care records to help to decide about your eligibility for a badge. This may avoid the need for an assessment.

Please see next page for information on providing supporting evidence for your application

Supporting Documents

In order for your application to be processed, you will need to include supporting evidence, such as those listed below. If you do not supply this evidence, we will be unable to process the application.

Please only attach copies of documents as we cannot return original documents.

A letter of diagnosis, as up-to-date as possible Evidence of the progression of the condition over time Confirmation of ongoing treatments/clinic attendances or referral for such – i.e. physiotherapy Evidence of prescribed medications relevant to your condition Evidence of specialist consultations or referrals for such Evidence of risk planning/assessment Your patient summary or Summary Care Records

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Section 5 – Consent to eligibility assessment

BB/Form/1aH Education Health and Care Plans (EHCP) Care plans from social care teams Social housing letters/assessment reports from local authority Letters from other professionals involved in your care Personal Independence Payment (PIP) decision letters Evidence of other benefits received Contact details of professionals who can support your application

Please list here which documents you are enclosing where possible:

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